Association Between Sex Hormone Levels And Non-valvular Atrial Fibrillation In Postmenopausal Women

Objective:The study analyzed the levels of estradiol,testosterone,homocysteine,uric acid and cystatin-C in postmenopausal women with non-valvular atrial fibrillation.The main purpose of this study was to analyze the effects of estradiol,testosterone,blood fat,uric acid,homocysteine and cystatin-c on non-valvular atrial fibrillation in postmenopausal women.In order to provide a theoretical basis for the treatment and prevention of atrial fibrillation.Methods:we retrospectively reviewed and analyzed 179 the post-women patients?age?50 years old?from October 2016 to October 2018 in the Department of Cardiology at second Hospital of Lanzhou University,107 postmenopausal women who diagnosed as non-valvular atrial fibrillation were analyzed as atrial fibrillation group according to inclusion and exclusion criteria.Seventy-two patients without atrial fibrillation in the same period were selected as control group.Baseline data?including age,body mass index,diabetes mellitus,coronary heart disease,hypertension,etc.?were recorded.The serum levels of estradiol,testosterone,uric acid and Cys-C,homocysteine,thyroid hormone were measured.The correlation between each group and subgroup was analyzed by SPSS20.0 software.Univariate Logistics regression analysis was used to screen the risk factors of atrial fibrillation in postmenopausal women.Multivariate Logistics regression was used to further verify the independent risk factors of atrail fibrillation to determine whether estradiol is a protective factor for the occurrence of atrail fibrillation in postmenopausal women,and the effects of blood fat,UA,Hcy and Cys-C on atrial fibrillation in postmenopausal women were analyzed.Result:?1?Compared with the control group,and the difference of homocysteine?Hcy?,serum uric acid?UA?,total cholesterol?TC?,triglyceride?TG?,low density lipoprotein cholesterol?LDL-C?,urea nitrogen?BUN?,serum creatinine?CREA?,left atrial diameter?LAD?were statistically significant?P<0.05?.There was no significant difference in estradiol?E₂?,testosterone?T?,Cys-C between the two groups?P>0.05?.?2?In the further multivariate Logistic regression analysis showed that the left atrium inner diameter LAD[OR=1.123,95%CI?1.013-1.245?,P<0.05],urea nitrogen BUN[OR=2.083,95%CI,?1.171-3.704?,P<0.05],All of them were independent risk factors of atrial fibrillation in the post-women patients.While homocysteine Hcy[OR=1.032,95%CI?0.939-1.134?,P>0.05],UA[OR=1.004,95%CI?0.997-1.012?,P>0.05)],total cholesterol TC[OR=0.259,95%CI?0.065-1.032?,P>0.05],triglyceride TG[OR=1.309,95%CI?0.713-2.401?,P>0.05],low density lipoprotein cholesterol LDL-C[OR=1.873,95%CI?0.559-6.281?,P>0.05],The levels of estradiol E₂[OR=0.957,95%CI?0.878-1.044?,P>0.05)and testosterone T[OR=1.028,95%CI?0.992-1.066?,P>0.05]were not independent risk factors for atrial fibrillation.?3?Comparing the clinical data of different age groups,we found that the difference of Hcy,UA,Cys-C,LAD,TC,TG,LDL-C,BUN,CREA between the two groups was statistically significant?P<0.05?in the middle-aged and old age group?74 years old.There was no significant difference in E₂ and T?P>0.05?.In the old age group?75years old,there was no significant difference in age,hypertension,diabetes,coronary heart disease,BMI,Hc,UA,Cys-C,T between the two groups?P>0.05?,there was significant difference in LAD,LDL-C,E₂.Further univariate Logistic regression analysis showed that LAD[OR=1.187,95%CI?1.049-1.344?,P<0.05],LDL-C[OR=0.310,95%CI?0.132-0.728?,P<0.05],E2[OR=1.116,95%CI?1.014-1.228?,P<0.05]were risk factors for atrial fibrillation in postmenopausal women.Conclusion:1.The increase of left atrial diameter and the increase of urea nitrogen were the independent risk factors of non-valvular atrial fibrillation in postmenopausal women,while total cholesterol,low density lipoprotein cholesterol,homocysteine,triglyceride,estradiol,testosterone,serum uric acid,cystatin-c might not be associated with the occurrence of atrial fibrillation in postmenopausal women.2.Elevated estradiol,reduced low density lipoprotein cholesterol and increased left atrial diameter were risk factors for non-valvular atrial fibrillation in postmenopausal women over 75 years old.